Serena Deann Wilkins, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

312719 Issued in LA

Practice address

3331 Youree Dr
Shreveport, LA 71105

Phone

(318) 868-6555

Fax

(318) 868-6009

NPI assigned

Apr 5, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Clinic of Doctors' Hospital

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1922156777

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1205290376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052115",
            "telephone_number": "318-868-6555",
            "fax_number": "318-868-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-868-6555",
            "fax_number": "318-868-6009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_2": "OB/GYN",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-675-8700",
            "fax_number": "318-675-8706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "SERENA",
        "middle_name": "DEANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "312719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2417401",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lekeshia Mishelay Wilkerson
• Miranda M Wilkerson, PT
• Christopher S. Wilkes
• Traci Michelle Wilkes
• Maloree Breanne Wilkins
• Andrew Wilkinson
• Christina Ashley Willard
• Grace Willcox
• Katlin Willey
• William D Parker MD and Willis-Knighton Medical Center

• Family Medicine Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.